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Legislative Corner - Hospital Privileges
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Legislative Corner

The Future of Nurse Practitioners in New Mexico: NPs & Hospital Privileges

Many nurse practitioners (NPs) in New Mexico provide a complete continuum of care for our patients. We see those patients in our practices, making diagnoses, providing treatment, writing prescriptions when needed and providing follow-up care. However, a problem occurs when we need to admit a patient to a hospital for other necessary care, such as surgery. In spite of the fact that we’re often patients’ primary care providers, hospitals in New Mexico have staff bylaws that prevent NPs from working at our fullest scope of practice. For example, those bylaws frequently require us to have a sponsoring physician in order to have allied staff privileges, some hospitals require a physician to cosign NP notes, and many do not allow NPs to admit patients. As the primary care providers for our patients, we know our patients’ cases more intimately than the attending physician staff at the hospital and are qualified and trained to oversee our patients’ care.

The Issue

NPs often don’t have the authority to supervise and coordinate care for our patients when they require hospitalization. This situation can slow the care process, decrease the level of interaction between NPs and our patients, and negatively impact their experiences and quality of care while hospitalized. Transition of care when patients leave the hospital is critical to reducing hospital readmissions. If patients’ primary care NPs supervised and coordinated their hospital care, there would be improvements in arranging post-hospital follow-up visits, reconciling medications, scheduling post-discharge testing, and obtaining hospital records important for on-going care. This would lead to higher patient satisfaction, increased medication safety, and better patient education.

The Result

This approach to care can put patients’ care at risk because it means that despite being our patients’ primary care providers, we don’t have the authority to act in their best interests. NPs in New Mexico are educated, trained and qualified to coordinate their patients’ hospital care. As their primary care providers, we know the intimate details of our patients’ health issues better than anyone else. This includes the details of how health problems have impacted their lives and the unique emotional burdens those issues impose on each patient. Hospital physicians may only review patients’ histories and current conditions without having all the historical and personal information that comes from having a long-term and close relationship with those patients. This forces them to start from scratch. It’s a process based largely on institutional logistics, rather than one that values having intimate knowledge of patients and using that information as the driving force behind their care.

The Action

Linda Siegle, the New Mexico Nurse Practitioner Council (NMNPC) lobbyist and longtime legal lobbyist in the healthcare field, has been carefully following and monitoring this issue for us. She works closely with NMNPC and the legislature, gathering information from practicing professionals and compiling data to present valuable and logical resolutions that put patient care first, while also improving the professional experience for NPs.

If you’d like to be more involved in legislative issues affecting NPs in New Mexico, please contact the NMNPC Executive Director: Rachel Bevan, BSN

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